Acquired palmoplantar keratodermas: A study of clinical, histopathological and patch test findings

Abstract

Background Palmoplantar keratodermas (PPK) are a group of conditions involving thickening of skin of palms and soles, and may be hereditary or acquired. Acquired PPKs (APPK) have diverse causes ranging from infections, systemic illness, malignancy or drugs and chemicals. This study aims at finding the prevalence of acquired PPK in dermatology outpatient department and to elucidate the cause and precipitating factors, if any. Methods This was a prospective one year study which evaluated dermatology outpatients for APPK. Patients were included after informed consent. Exclusion criteria included hereditary causes for PPK.  A structured and detailed history, clinical and systemic examination, along with histopathology and patch test was carried out. There were a total of 26 patients, with equal sex distribution. Results Prevalence of APPK was 0.17/100 patients, with equal sex distribution. Average age of onset was 41-50, average age at presentation was 51-60 years. Psoriasis was the single common cause (16 patients) followed by eczemas (8 patients). Histopathology and patch test were helpful in diagnosis. Conclusion APPK is mostly seen in middle age, with equal gender predisposition. Palmoplantar psoriasis is still the major single cause.  Approach to APPK is mostly clinical, with histopathology and patch test being helpful in selected cases.